Sample Settlements and Verdicts The following are merely a sample of the matters the firm has handled in litigation. A great many of our cases have been quickly and successfully resolved even before a lawsuit had to be filed. 1. Doe v. Standard Ins. Co (U.S. District Court for the Northern District of Georgia, ERISA Long Term Disability). Our client, a 48-year-old obstetrician/gynecologist, sued his disability insurer under ERISA for long term disability benefits. In 1996 Plaintiff underwent open heart surgery, which was generally successful in curing his cardiac problem. However, after the surgery the Plaintiff's family noticed problems with his memory, attention, concentration and mood, which did not resolve over time. Plaintiff's doctors evaluated him and said he could not competently work as a doctor, so he applied for long term disability benefits. The insurer question whether Plaintiff's cognitive problems were real and/or disabling. We developed extensive expert proof that: (1) he had suffered a common complication of open heart surgery resulting in microscopic damage to his brain; and (2) that this brain injury disabled Plaintiff from practicing medicine. Standard relied on its own group of experts who asserted that the medical situation was unusual and/or not disabling. Plaintiff filed suit in federal court under ERISA. And prevailed on a motion for partial summary judgment that: (1) Plaintiff was entitled to de novo review of Defendant's denial of the claim under ERISA precedent (defeating Defendant's assertion that their claims denial was entitled to deferential treatment by the Court); and (2) if Plaintiff could prove his disability resulted from physical damage to his brain, Defendant could not limit benefits to 24 months under a "mental disorder" limitation. As a result of these rulings, Defendant faced exposure for paying $6,000.00 per month until Plaintiff reached age 65, plus interest and attorney fees, with total exposure exceeding $1,000,000.00. The case settled on confidential terms after mediation. Morris v. CNA (U.S. District Court for the Northern District of Georgia, ERISA Long Term Disability) - Plaintiff, a 43 year old word processor/typist by profession, sued for wrongfully denied long term disability benefits under ERISA based upon chronic fatigue syndrome. Her treating physicians recommended that she cease working. Plaintiff applied for LTD benefits, which CNA turned down. Plaintiff applied for and was accepted for Social Security disability benefits. On the basis of the Social Security finding and the medical opinions of her doctors, Plaintiff repeatedly appealed to CNA to reverse their decision, but the appeals were denied. Plaintiff filed suit, seeking monthly benefits and attorneys' fees. After the parties filed cross motions for judgment, the Court remanded the claim to CNA for further development of medical evidence, and awarded Plaintiff her attorney fees. Following this ruling, the claim was quickly settled for one hundred percent of the net present value of the benefits exposure, plus the reasonable value of the claimed attorney fees. Doe v. Provident Life & Accident (U.S. District Court for the Northern District of Georgia, Long Term Disability) - We represented a 55 year old long time insurance salesman and financial planner. In the early 1980's he purchased two disability policies from defendant. In 1990 plaintiff suffered a bout of major depression and in-patient hospitalization. He returned to work full time, full duties, but at reduced effectiveness due to a continuing diagnosis of depression vs. dysthymia (a minor, chronic form of
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depression resulting in impaired concentration, impulsivity, a lack of motivation, etc). As a result of his diminished capacity, the plaintiff's income never approached his predisability levels. Defendant initially accepted the claim, paying residual disability benefits of $4,500.00 per month, but also subjected plaintiff to multiple medical examinations over the years, many of which questioned the diagnosis and/or extent of his disability. Defendant unilaterally suspended benefits on December 31, 1997, based upon four adverse medical opinions, . Plaintiff filed suit alleging breach of contract and bad faith denial of insurance benefits under O.C.G.A. ß 33-4-6. Plaintiff's counsel's investigation of the claim revealed that the Defendant's medical examiners' analysis was flawed and unreliable, and that the Defendant had not disclosed policy improvements issued to all policyholders which substantially liberalized the definition of residual disability. The claim involved net present value exposure for future benefits of approximately $850,000.00. After the above information was disclosed in a settlement conference, the case settled for a confidential sum. Benefits had also been suspended under a third disability policy taken out by Plaintiff with another insurer not made party to the lawsuit. Much to the client's delight, counsel was able to get benefits reinstated on this policy merely by advising the insurer of the outcome of the earlier litigation. Jones v. Guffin (Superior Court of Fulton County, Medical Malpractice). Mr. Warncke's plaintiff/client was a professional singer/hip hop performer who had a platinum record and two Grammy awards to her credit. She decided to return to college to formally study voice, and noticed increasing symptoms of hoarseness. She consulted the Defendant physician, who diagnosed vocal nodules on both vocal folds, and quickly recommended and performed surgery. The plaintiff's lawsuit alleged that the Defendant physician performed a surgical technique known as "vocal stripping" which had been out of favor for decades, and which was never acceptable for performing on both vocal folds in the same sitting. Vocal stripping involves removal of a layer of tissue from the vocal fold. Since both sides of plaintiff's folds were operated on at the same time, the two sides developed scar tissue and grew together, restricting the airway, and permanently immobilizing the vocal chords causing permanent loss of voice. Suit was filed and extensive discovery was taken, after which the case settled at mediation on confidential terms. Doe v. Signature (Superior Court of Fulton County, Premises Liability/Negligent Security). This tragic case arose from negligent security at a downtown Atlanta perking deck which allowed the plaintiff to be sexually assaulted. Mr. Warncke retained numerous experts and engaged in aggressive discovery, revealing serious deficiencies in the landowner's security measures. Discovery revealed that the parking deck had been the site of dozens of crimes every year. Despite this, the landowner rarely patrolled the area. The parking deck was supposed to be controlled, authorized access only, but plaintiff's assailant followed her into the deck through a door whose lock had been broken for weeks, if not months. The assault occurred near a security camera which was not working. Finally, we discovered that the owner was undertaking a multi-million dollar renovation of the property, and had hired its own security consultant in the process. The defendant's security consultant had recommended numerous upgrades to security near the area of the assault. Plaintiff contended that her assault would have been avoided if the landowner had only followed the advice of its own consultant. The case settled on confidential terms after mediation. Depass v. AIG Life Insurance Company (ERISA Life Insurance, pre-suit resolution by
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payment of benefits). Life insurance claim involving some very unusual and poorly worded language defining qualifications for coverage. The insurer read the policy in such a way as to deny coverage. The firm conducted legal research, wrote a few letters, and persuaded the insurer they had read the policy the wrong way, and that the plaintiff was entitled to benefits. The insurer voluntarily paid the entire claim. Doe v. Metropolitan Life Ins. Co. (U.S. District Court for the Northern District of Georgia, Private Long Term Disability and Insurance Bad Faith). Former family practice doctor disabled by substance dependency, and who also became blind in one eye after his disability started. Client's submissions to the insurer did not address his blindness. We filed suit, and asked the insurer to re-evaluate its position in light of the client's vision problems. The case eventually settled confidentially. Cheal v. Life Insurance Company of North America (U.S. District Court for the Northern District of Georgia, ERISA Long Term Disability). This was a fairly straightforward claim for disability benefits, but before the case settled it yielded a reported decision generally helpful to ERISA claimants in this jurisdiction. Over the insurer's objection, Judge Thrash held that the insurer could be held liable for statutory penalties for failing to produce documents despite not bet being the named "plan administrator." The order also confirmed that the plaintiff was entitled to prejudgment interest on wrongfully denied benefits. Anthony v. Aetna Life Insurance Company (U.S. District Court for the Northern District of Georgia, ERISA Long Term Disability). This was a very interesting disability case involving the somewhat rare middle ear condition known as endolymphatic hydrops, a precursor to Meniere's disease. The firm assisted in developing persuasive medical evidence, including additional testing for the plaintiff, which explained his diagnosis, exactly how it arose, and how it was disabling. Although the insurer's medical consultants asserted Mr. Anthony was not disabled, counsel proved serious flaws in their methodology and reasoning. At the conclusion of discovery the case went to mediation and settled on confidential terms. Life Insurance Trusts v. Indianapolis Life Insurance Company (Life Insurance, Bad Faith). This case involved the pre-suit settlement of several life insurance claims for $6,500,000.00, over 90% of the value of the policies. The Insurer wrote $7,000,000.00 in coverage on an 8o year old man wit a history of bladder cancer, longstanding high blood pressure and a first degree atrioventricular block. The insured dies less than two years after becoming insured, and the insurer denied the claims, asserting that the insured did not disclose important information about his cardiac history on his policy applications. Counsel developed expert proof that demonstrated that the insured disclosed everything of which he was aware, that the insurance company knew everything it needed to know to make its underwriting decision, and that its asserted defense was illegal. After considering counsel's letter requesting reconsideration, the insurer settled the claims for 93% of the value of the policies. Tippitt v. Reliance Standard Life Insurance Co. (ERISA Long Term Disability). This case resulted in a favorable reported decision from the Eleventh Circuit Court of Appeals. The Court rejected a reading of disability policies which would unfairly deny a broad class of claims, and adopted a more practical, realistic analysis of competitive employment for analyzing disability claims.